Long-term effects of widowhood after terminal cancer: a Swedish nationwide follow-up

Abstract

Aims: The authors investigated whether becoming a widow after the death of a husband from cancer results in long-term psychological or physical morbidity.

Method: In April and May 1999, an attempt was made to contact all of the 506 women who were living with men dying of prostate cancer in 1996 or of urinary bladder cancer in 1995 or 1996, as well as 287 population controls.

Results: Completed questionnaires were received from 379 of the widows and 220 of the controls. Widowhood was associated with a low or moderate subjective quality of life (relative risk [RR]=1.4, 95% confidence interval 1.2—1.7), low or moderate psychological well-being (RR=1.8, 1.4—2.3), anxiety (RR=1.9, 1.3—2.7), depression (RR=2.2, 1.6—2.9), sleep disturbances (RR=1.9, 1.5—2.4), diabetes (RR=3.5, 1.2—7.9), and economic dissatisfaction (RR=1.6, 1.3—2.0).

Conclusion: An excess risk of psychological morbidity, diabetes mellitus and dissatisfaction with the economic situation was found in the widowed population.

Keywords

adaptation chronic death illness morbidity psychological widowhood.

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References

Zisook S. , Shuchter SR Early psychological reaction to the stress of widowhood. Psychiatry 1991; 54: 320—33.

Zisook S. , Shuchter SR Depression through the first year after the death of a spouse. Am J Psychiatry 1991; 148: 1346—52.

Jacobs S. , Hansen F. , Berkman L. , Kasl S. , Ostfeld A. Depressions of bereavement. Compr Psychiatry 1989; 30: 218—24.

Jacobs S. , Hansen F. , Kasl S. , Ostfeld A. , Berkman L. , Kim K. Anxiety disorders during acute bereavement: risk and risk factors. J Clin Psychiatry 1990; 51: 269—74.

Surtees PG In the shadow of adversity: the evolution and resolution of anxiety and depressive disorder. Br J Psychiatry 1995; 166: 583—94.

Turvey CL , Carney C. , Arndt S. , Wallace RB , Herzog R. Conjugal loss and syndromal depression in a sample of elders aged 70 years or older. Am J Psychiatry 1999; 156: 1596—1601.

Doi Y. , Minowa M. , Okawa M. , Uchiyama M. Prevalence of sleep disturbances and hypnotic medication use in relation to sociodemographic factors in the general Japanese adult population. J Epidemiol 2000; 10: 79—86.

Avis NE , Brambilla DJ , Vass K. , McKinlay JB The effect of widowhood on health: a prospective analysis from the Massachusetts women's health study. Soc Sci Med 1991; 33: 1063—70.

Byles JE , Feldman S. , Mishra G. For richer, for poorer, in sickness and in health: older widowed women's health, relationships and financial security. Women Health 1999; 29:15—30.

10.

Rosenbloom CA , Whittington FJ The effects of bereavement on eating behaviors and nutrient intakes in elderly widowed persons. J Gerontol 1993; 48: 223—9.

11.

Mellström D. , Nilsson A. , Oden A. , Rundgren A. , Svanborg A. Mortality among the widowed in Sweden. Scand J Soc Med 1982; 10: 33—41.

12.

Spielberger CD , Gorsuch RL , Lunshene PR , Vagg PR , Jacobs GA Manual for the State-Trait Anxiety Inventory (form Y). Palo Alto, CA: Consulting Psychologists Press, 1983.

13.

Radloff LS The CES-D Scale: a self-report depression scale for research in the general population. Appl Psychol Meas 1994; 1: 385—401.

14.

Tibblin G. , Tibblin B. , Peciva S. , Kullman S. , Svardsudd K. `The Goteborg quality of life instrument' — an assessment of well-being and symptoms among men born 1913 and 1923. Methods and validity. Scand J Prim Health Care Suppl 1990; 1: 33—8.

15.

Bergmark K. , Avall-Lundqvist E. , Dickman PW , Henningsohn L. , Steineck G. Vaginal changes and sexuality in women with a history of cervical cancer. N Engl J Med 1999; 340: 1383—9.

16.

Radestad I. , Steineck G. , Nordin C. , Sjogren B. Psychological complications after stillbirth: influence of memories and immediate management: population based study. Br Med J 1996; 312: 1505—8.

17.

Helgason AR , Adolfsson J. , Dickman P. , Fredrikson M. , Arver S. , Steineck G. Waning sexual function — the most important disease: specific distress for patients with prostate cancer. Br J Cancer 1996; 73: 1417—21.

18.

Rothman KJ , Greenland S , editors. Modern epidemiology. 2nd edn. Philadelphia: Lippincott-Raven, 1998.

19.

Bennet KM A longitudinal study of well being in widowed women. Int J Geriatr Psychiatry 1997; 12: 61—6.

20.

Zisook S. , Chentsova-Dutton Y. , Shuchter SR PTSD following bereavement. Ann Clin Psychiatry 1998; 10: 157—63.

21.

Mergenhagen PM , Lee BA , Grove WR Till death us do part: recent changes in the relationship between marital status and mortality. Sociol Social Res 1985; 70: 53—6.

22.

Mooy JM , de Vries H. , Grootenhuis PA , Bouter LM , Heine RJ Major stressful life events in relation to prevalence of undetected type 2 diabetes: The Horn Study. Diabetes Care 2000 ; 23: 197—201.

23.

Quandt SA , McDonald J. , Arcury TA , Bell RA , Vitolins MZ Nutritional self-management of elderly widows in rural communities. Gerontologist 2000; 40: 86—96.

24.

Prigerson HG , Maciejewski PK , Rosenheck RA The effects of marital dissolution and marital quality on health and health service use among women. Medical Care 1999; 37: 858—73.